The recent and dramatic increase in the obesity prevalence has been followed closely by a rapidly rising prevalence of metabolic complications, especially diabetes and the metabolic syndrome, a well recognized, but poorly understood condition involving lipid, glucose and hormonal dysregulation associated with increased risk for cardiovascular disease. The prevalence of MS has increased significantly among adults over the last 20 years to 23.7%. More worrisome, over 30% of overweight adolescents in the NHANES 1999- 2000 survey were found to have a MS phenotype. Obesity and diabetes are common among certain ethnic groups including Asians, Native Hawaiians and other Pacific Islanders (PI). MS is also more common among certain ethnic groups including NH and Asians adults, especially Filipinos. Filipino, NH and other PI children have a high prevalence of obesity but prevalence of MS is not known. In light of the high prevalence of childhood obesity and adult MS, Filipino, NH and other PI children may be particularly susceptible to the development of MS. Physiologic abnormalities that appear to be MS may be reversible initially but become stable later and much more difficult to treat. This reversibility underscores the idea that in order to understand MS, and develop effective prevention and treatment programs, we need to understand how it develops in childhood, especially in diverse, high-risk populations such as Asian and PI. The specific aims of this study are to 1) To determine the prevalence of MS in a high-risk population of overweight Filipino, NH, and Samoan adolescents 2) To examine the pattern of physical and laboratory markers associated with the development MS in a high-risk population of children 3) To examine the relationship between gestational and early childhood factors and the development of MS/ The study will be a cross-sectional community-based study of 450 Filipino, NH and Samoan overweight and at risk for overweight youth recruited from community health centers in Hawaii and surrounding community groups. Subjects will undergo anthropometric measurement, body composition analysis and laboratory studies to determine which overweight adolescents have a MS phenotype. Medical records will be reviewed to collect pregnancy, child growth data and determine associations with the development of MS. PUBLIC: Metabolic syndrome (MS) is a common and serious consequence of obesity involving problems with lipid, glucose and blood pressure regulation and increases risk of developing cardiovascular disease. Like obesity, it is becoming more common in children but little is known about how it develops. This study will determine how common MS is in a population of high-risk, understudied Asian and Pacific Island children and examine the relationship between factors in pregnancy and early childhood and the onset of MS.